When medication fails to ease the symptoms of clinical depression, there are other options to try. For example, electroconvulsive therapy (ECT) as well as vagus nerve stimulation (VNS) can be used to treat severe depression and major depression that has proven resistant to treatment. With ECT, an electric current is briefly applied through the scalp to the brain, inducing a seizure. VNS uses a device known as a vagus nerve stimulator to alleviate depression. In addition, alternative therapies such as yoga and hypnosis sometimes work for mild depression.

What is electroconvulsive therapy (ECT)?

ECT is safe and among the most effective treatments available for depression. With ECT, electrodes are put on the patient's scalp and a finely controlled electric current is applied. The current causes a brief seizure in the brain. ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients. It's also very effective for patients who suffer from mania or other mental illnesses.

ECT is generally used when severe depression is unresponsive to other forms of therapy. Or it might be used when patients pose a severe threat to themselves or others and it is dangerous to wait until medications take effect.

Although ECT has been used since the 1940s and 1950s, it remains misunderstood by the general public. Many of the procedure's risks and side effects are related to the misuse of equipment, incorrect administration, or improperly trained staff. It is also a misconception that ECT is used as a "quick fix" in place of long-term therapy or hospitalization. Nor is it correct to believe that the patient is painfully "shocked" out of the depression. Unfavorable news reports and media coverage have contributed to the controversy surrounding this treatment.

How is ECT done?

Prior to ECT treatment, a patient is given a muscle relaxant and is put to sleep with a general anesthesia. Electrodes are placed on the patient's scalp and a finely controlled electric current is applied. This current causes a brief seizure in the brain.

Because the muscles are relaxed, the visible effects of the seizure will usually be limited to slight movement of the hands and feet. Patients are carefully monitored during the treatment. The patient awakens minutes later, does not remember the treatment or events surrounding it, and is often confused. The confusion typically lasts for only a short period of time.

When used, ECT is usually given up to three times a week for a total of two to four weeks.